Acquired CDK6 amplification promotes breast cancer resistance to CDK4/6 inhibitors and loss of ER signaling and dependence Journal Article


Authors: Yang, C.; Li, Z.; Bhatt, T.; Dickler, M.; Giri, D.; Scaltriti, M.; Baselga, J.; Rosen, N.; Chandarlapaty, S.
Article Title: Acquired CDK6 amplification promotes breast cancer resistance to CDK4/6 inhibitors and loss of ER signaling and dependence
Abstract: Dysregulated activation of the CDK4/6 kinases is a hallmark of most mammary-derived carcinomas. ATP-competitive inhibitors against this complex have been recently advanced in the clinic and have shown significant activity, particularly against tumors driven by the estrogen receptor (ER). However, resistance to these compounds has begun to emerge often months to years after their initiation. We investigated potential mechanisms of resistance using cell line models that are highly sensitive to this class of drugs. After prolonged exposure to the selective and potent CDK4/6 inhibitor LY2835219, clones emerged and several were found to harbor amplification of the CDK6 kinase. Amplification of CDK6 resulted in a marked increase in CDK6 expression and reduced response of the CDK4/6 target, phospho-Rb (pRb), to CDK4/6 inhibitors. Knockdown of CDK6 restored drug sensitivity, while enforced overexpression of CDK6 was sufficient to mediate drug resistance. Not only did CDK6 overexpression mediate resistance to CDK4/6 inhibitors but it also led to reduced expression of the ER and progesterone receptor (PR), and diminished responsiveness to ER antagonism. The reduced ER/PR expression after CDK4/6 inhibitor resistance was additionally observed in tumor biopsy specimens from patients treated with these drugs. Alternative mechanisms of resistance to CDK4/6 inhibitors such as loss of pRb and cyclin E1 overexpression also exhibited decreased hormone responsiveness, suggesting that the clinical paradigm of sequential endocrine-based therapy may be ineffective in some settings of acquired CDK4/6 resistance.
Journal Title: Oncogene
Volume: 36
Issue: 16
ISSN: 0950-9232
Publisher: Nature Publishing Group  
Date Published: 2017-04-20
Start Page: 2255
End Page: 2264
Language: English
DOI: 10.1038/onc.2016.379
PUBMED: 27748766
PROVIDER: scopus
PMCID: PMC5393973
DOI/URL:
Notes: Article -- Export Date: 1 June 2017 -- Source: Scopus
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MSK Authors
  1. Neal Rosen
    425 Rosen
  2. Dilip D Giri
    184 Giri
  3. Maura N Dickler
    262 Dickler
  4. Zhiqiang Li
    10 Li
  5. Jose T Baselga
    484 Baselga
  6. Maurizio Scaltriti
    169 Scaltriti
  7. Trusha   Bhatt
    6 Bhatt
  8. Chengcheng Yang
    1 Yang